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mini-bonds-registration-form1.php
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mini-bonds-registration-form1.php
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<?php
function minibond_registration_step1() {
$mh = new MiniBondsHelper;
$settitle = isset($_POST['settitle']) ? $_POST['settitle'] : '';
$firstname = isset($_POST['firstname']) ? $_POST['firstname'] : '';
$surname = isset($_POST['surname']) ? $_POST['surname'] : '';
$birthdayday = isset($_POST['birthdayday']) ? $_POST['birthdayday'] : '';
$setmonth = isset($_POST['setmonth']) ? $_POST['setmonth'] : '';
$birthdayyear = isset($_POST['birthdayyear']) ? $_POST['birthdayyear'] : '';
$email = isset($_POST['email']) ? $_POST['email'] : '';
$emailconfirm = isset($_POST['emailconfirm']) ? $_POST['emailconfirm'] : '';
$homephone = isset($_POST['homephone']) ? $_POST['homephone'] : '';
$mobilephone = isset($_POST['mobilephone']) ? $_POST['mobilephone'] : '';
?>
<div class="row registration-container step1">
<div class="col-xs-12 col-md-12 col-lg-12">
<div class="row col-xs-12 col-md-6 col-lg-6">
<h1 class="register-account-title">INVESTMENT PROCESS</h1>
<p class="reg_desc"><strong>To register for your account follow these 4 easy steps.</strong></p>
</div>
<div class="col-sm-12 col-xs-12 col-md-6 col-lg-6 nopadding">
<img src="<?php echo plugins_url( 'img/step1.png', __FILE__ ) ?>" alt="Registration Steps 1" class="register-steps pull-right" />
</div>
</div>
<div class="col-sm-12 col-xs-12 col-md-12 col-lg-12">
<h2 class="smaller form-title">PERSONAL DETAILS</h2>
</div>
<div class="col-sm-12 col-xs-12 col-md-12 col-lg-12">
<form method="post" name="minibonds-registrationForm" id="minibonds-registrationForm" role="form" novalidate="">
<input type="hidden" name="step1" value="true" />
<div class="row">
<div class="col-xs-12 col-md-6">
<div class="form-group">
<label for="seltitle">Title: <span class="red">*</span></label>
<div class="col-xs-12 col-md-12 nopadding">
<select id="seltitle" name="settitle" class="form-control" data-parsley-required="" data-parsley-error-message="Missing title" data-parsley-errors-container="#titleerror">
<option value="">Title</option>
<option value="Mr" <?php echo $mh->mini_bonds_is_selected('Mr', $settitle); ?>>Mr</option>
<option value="Mrs" <?php echo $mh->mini_bonds_is_selected('Mrs', $settitle); ?>>Mrs</option>
<option value="Miss" <?php echo $mh->mini_bonds_is_selected('Miss', $settitle); ?>>Miss</option>
<option value="Ms" <?php echo $mh->mini_bonds_is_selected('Ms', $settitle); ?>>Ms</option>
<option value="Dr" <?php echo $mh->mini_bonds_is_selected('Dr', $settitle); ?>>Dr</option>
</select>
<div id="titleerror" style="margin-bottom: 24px;"></div>
</div>
</div>
<div class="form-group">
<label for="firstname">First Name: <span class="red">*</span></label>
<input type="text" class="form-control" id="firstname" name="firstname" value="<?php echo $firstname; ?>" data-parsley-required="true" data-parsley-error-message="Please enter your first name" />
</div>
<div class="form-group">
<label for="surname">Surname: <span class="red">*</span></label>
<input type="text" class="form-control" id="surname" name="surname" value="<?php echo $surname; ?>" data-parsley-required="true" data-parsley-error-message="Please enter your surname" />
</div>
<div class="form-group">
<label for="birthday">Date of Birth: <span class="red">*</span></label>
<div class="row">
<div class="col-xs-12 col-md-12 nopadding">
<div class="col-xs-12 col-md-4">
<input class="form-control" id="birthdayday" name="birthdayday" style="height: 30px;" size="2" maxlength="2" minlength="2" data-parsley-minlength="1" data-parsley-min="1" data-parsley-type="integer" type="text" data-parsley-max="31" data-parsley-required="true" data-parsley-errors-container="#birthdayerror" data-parsley-error-message="Please enter a valid day" value="<?php echo $birthdayday; ?>" />
</div>
<div class="col-xs-12 col-md-4 text-center">
<select id="selmonth" name="setmonth" class="form-control" data-parsley-dobvalidation="" data-parsley-validate-if-empty="" data-parsley-errors-container="#birthdayerror">
<option value="">Month</option>
<option value="1" <?php echo $mh->mini_bonds_is_selected('1', $setmonth); ?>>January</option>
<option value="2" <?php echo $mh->mini_bonds_is_selected('2', $setmonth); ?>>Febuary</option>
<option value="3" <?php echo $mh->mini_bonds_is_selected('3', $setmonth); ?>>March</option>
<option value="4" <?php echo $mh->mini_bonds_is_selected('4', $setmonth); ?>>April</option>
<option value="5" <?php echo $mh->mini_bonds_is_selected('5', $setmonth); ?>>May</option>
<option value="6" <?php echo $mh->mini_bonds_is_selected('6', $setmonth); ?>>June</option>
<option value="7" <?php echo $mh->mini_bonds_is_selected('7', $setmonth); ?>>July</option>
<option value="8" <?php echo $mh->mini_bonds_is_selected('8', $setmonth); ?>>August</option>
<option value="9" <?php echo $mh->mini_bonds_is_selected('9', $setmonth); ?>>September</option>
<option value="10" <?php echo $mh->mini_bonds_is_selected('10', $setmonth); ?>>October</option>
<option value="11" <?php echo $mh->mini_bonds_is_selected('11', $setmonth); ?>>November</option>
<option value="12" <?php echo $mh->mini_bonds_is_selected('12', $setmonth); ?>>December</option>
</select>
</div>
<div class="col-xs-12 col-md-4">
<input type="text" class="form-control" id="birthdayyear" name="birthdayyear" style="height: 30px;" size="4" maxlength="4" data-parsley-minlength="4" data-parsley-required="true" data-parsley-type="integer" data-parsley-errors-container="#birthdayerror" data-parsley-error-message="Please enter a valid year (YYYY)" value="<?php echo $birthdayyear; ?>" />
</div>
</div>
</div>
<div id="birthdayerror"></div>
</div>
</div>
<div class="col-xs-12 col-md-6">
<div class="form-group">
<label for="email">Email Address: <span class="red">*</span></label>
<input type="email" class="form-control" id="email" name="email" value="<?php echo $email; ?>" data-parsley-required="true" data-parsley-error-message="Please enter your email address" />
</div>
<div class="form-group">
<label for="emailconfirm">Confirm Email Address: <span class="red">*</span></label>
<input type="email" class="form-control" id="emailconfirm" name="emailconfirm" value="<?php echo $emailconfirm; ?>" data-parsley-required="true" data-parsley-error-message="Please confirm your email address" data-parsley-equalto="#email" />
<div class="parsley-custom-error-message emailvalidation" id="emailvalidation"></div>
</div>
<div class="form-group">
<label for="homephone">Home Phone: <span class="red">*</span></label>
<input type="text" maxlength="20" class="form-control" id="homephone" name="homephone" value="<?php echo $homephone; ?>" data-parsley-required="true" data-parsley-error-message="Please enter a UK landline number" />
</div>
<div class="form-group">
<label for="mobilephone">Mobile Phone: </label>
<input type="text" maxlength="20" class="form-control" id="mobilephone" name="mobilephone" value="<?php echo $mobilephone; ?>" />
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-md-6"><br /><br />
<a href="#" style="color: #0f3269 !important;" target="_blank">Applying in the name of a company?</a>
</div>
<div class="col-xs-12 col-md-6"><input type="submit" class="btn btn-success continue" value="CONFIRM" /></div>
</div>
</form>
</div>
<div class="col-xs-12 col-md-12 bottom-tel">
<div class="col-xs-1 col-md-1">
<img src="<?php echo plugins_url( 'img/icon_call_us.png', __FILE__ ) ?>" alt="Telephone Number" class="pull-left" />
</div>
<div class="col-xs-11 col-md-11">
<h2>If you have any problem please feel free to call us <a href="tel:03456076001" style="color: #0f3269 !important;">0345 607 6001</a></h2>
<span>Monday - Friday 07:30-21:00 - Saturday 09:00-15:00</span>
</div>
</div>
</div>
<?php
}